The Charnley-Hastings Hemiarthroplasty for Fractures of the Femoral Neck with Special Reference to Complications

We report a retrospective study of the incidence of major complications following Charnley-Hastings bipolar hemiarthroplasty in 117 patients with 120 fractures of the femoral neck. Primary hemiarthroplasty (n=40) was used for irreducible or old fractures and secondary hemiarthroplasty (n=80) for fractures with disturbed healing. The mean age was 80 (54-95) years. The mean follow-up was 34 (0-149) months. There was no major complication in 87.2 percent. Mortality was 10.3 percent after 6 months and 13.7 percent after one year. Dislocation occurred in 7.5 percent, prosthetic loosening in 4.2 percent, acetabular fracture and deep infection in 0.8 percent respectively. Reoperation was required in 7.5 percent: open reduction after dislocation (2.5 percent), conversion to a Charnley total hip arthroplasty (3.3 percent), Girdlestone arthroplasty (0.8 percent) and exchange of a loose femoral component (0.8 percent). We conclude that the selective use of bipolar hemiarthroplasty for fractures of the femoral neck carries few major complications. Patient selection must be strict in order to reduce the risk of dislocation.